Contaminated Blood (Support for Infected and Bereaved Persons) Bill [HL]

The Government relieve suffering that they have no obligation to relieve in many different ways. Indeed, they are doing so in this case, too. I return to the clause that we are addressing. I absolutely appreciate that people feel very strongly and are angry about this issue. We have decided to increase payments to those infected with HIV to a minimum of £12,800 each. The two trusts have the power to make discretionary payments to infected individuals as well as widows and dependants within the annual budget allocation available to them. In addition, the Skipton fund has so far paid nearly £100 million to those infected with hepatitis C. The Government have committed to review the Skipton fund in 2014. I look forward to the findings of the Penrose inquiry in Scotland; we should take those into account. I have a great deal of personal sympathy with the remarks of my noble and learned friend Lord Archer about the review date. Perhaps I need to ask my honourable friend in another place to look at this again. I understand the plight of those affected by this tragedy. That is why we have already paid almost £150 million to those affected. In Clause 5 of the Bill, which requires a review of several issues, all of which were covered in our response to the report of my noble and learned friend Lord Archer, again the question is put of whether there is any benefit in putting this work on a statutory footing. For example, in respect of insurance, the Association of British Insurers has assured us that insurers do not treat haemophilia patients or those affected only with HIV or hepatitis C differently from people with other pre-existing conditions. In all cases, a person’s insurability and the level of premiums are determined by the assessment of their individual risk. Clearly, there are likely to be costs in obtaining such insurance. That is one of the factors that the Government took into account in deciding to increase the annual payments to those infected with HIV to a minimum of £12,800. I return to some of the particular points raised by individual noble Lords. My noble friend Lord Morris and the noble Baroness, Lady Masham, raised issues to do with vCJD. What have we done to address those issues? Evidence of variant CJD infection was recently found in the autopsy of a haemophilia patient in their seventies, who died from unrelated causes. However, the patient had displayed no symptoms of variant CJD or any other neurological conditions prior to death. Haemophilia patients who receive donor-derived clotting factors have previously been informed by clinicians of their increased risk of exposure to vCJD via clotting factors. This finding will undoubtedly have caused concern, as mentioned by the noble Baroness, among those who suffer from haemophilia and other bleeding disorders. However, the finding does not increase the risk to those patients, or mean any change to the way that they are treated. Our priority has been to address the patients’ concern and ensure that they are able to obtain advice about this new finding and how it may affect them. This is an important part of our work with the Haemophilia Alliance. The noble Baroness, Lady Masham, asked about filtering blood and prion filtration. The Spongiform Encephalopathy Advisory Committee, which is the Government’s independent expert scientific committee on vCJD, recommended that filters undergo independent efficacy trials. The blood service has commissioned an independent assessment for the efficacy of prion filters currently on the market and is undertaking its own assessment of the quality and clinical safety of filtered red cells. As the results become available, they are considered by the UK National Blood Service’s prion removal working group. The independent committee on safety of blood tissues and organs, SaBTO, with which noble Lords will be familiar, will advise on whether this technology should be considered for introduction. SaBTO has recently advised that it considers that there is now sufficient evidence that a particular filter is able to reduce infectivity in a unit of red blood cells, and has recommended the introduction of filtered blood to under-16s subject to satisfactory completion of clinical trials to assess safety. We are undertaking an evaluation of the cost, benefit and impact of implementing that recommendation. The noble Lords, Lord Morris and Lord Thomas, referred to Crown immunity. I do not feel that the subject is appropriate, partly because it is not really included in the Bill. However, I will say that I understand that the activities of the BPL were covered by Crown immunity so were outside the requirements of the Medicines Act until 1991. That immunity protected not from civil suit but only from prosecution under the Medicines Act. Indeed, some affected person brought action in 1990 that was settled out of court. Affected persons therefore have the right of redress through civil law. However, our legal advice is that an act of retrospection to permit prosecutions under the Medicines Act after all this time would not be accepted by the courts as valid. My noble friend Lord Morris and the noble Lord, Lord Jenkin, asked why the Department of Health did not give evidence. Indeed, I shall address several inquiries about evidence together, including those from the noble Lord, Lord Thomas, and my noble friend Lord Rooker. The noble and learned Lord, Lord Archer, asked that someone from the department meet him, and officials have done so on several occasions. I would say that we had gone further than any previous Administration in making information for the relevant period available. In total, 5,500 official documents have been released, and Department of Health officials have met the inquiry team several times to talk them through the documentation. Given that no one working in the department has direct knowledge of these events from the 1970s and 1980s, there is no additional evidence that any individual could contribute to the inquiry. We regret deeply that some documents were inadvertently destroyed. However, I repeat that 5,500 documents relating to the period have been released and are on the website. I am sad that my noble friend Lord Rooker berated me and suggested impropriety in the department. However, he is right that there is still work to be done. Maybe his suggestion, supported by the noble Baroness, Lady Barker, has merit. The last tranche of the documents were indeed released after the inquiry had completed its consideration, but we partly released them in good faith, to show that we were trying to be transparent. They were available to the public and of course have been made available to the Penrose inquiry. The noble Lord, Lord Low, asked about financial relief. There are good reasons to maintain the established mechanism for paying for financial relief. The Eileen Trust and the Macfarlane Trust have developed good relationships with their registrants over the years. This is not a case of going cap in hand. There is a discretionary element in the size of payments that they make. Those decisions are best made by the charitable trust, with its deep understanding of the small group of people with whom it works, rather than by civil servants. The noble Baroness, Lady O’Cathain, and other noble Lords raised the issue of funding to the Haemophilia Society. We are providing £100,000 to the Haemophilia Society each year for five years to enable it to move to secure financial funding. In addition, there are always possibilities for it to contract with the department on other, project-based issues. She also raised the issue of the future safety of blood. The European directive set standards of quality and safety for the collecting, testing, processing, storage and distribution of human blood and blood components. NHS Blood and Transplant is responsible for ensuring a sufficient, safe supply of blood to meet the needs of patients in England and north Wales. This includes a clear responsibility to minimise the risk of blood transfusions transmitting infection to patients. The Independent Advisory Committee on the Safety of Blood, Tissues and Organs advises the UK health departments on blood safety measures. The noble Baroness, Lady Masham, raised the issue of our self-sufficiency in blood products, as did the noble Lord, Lord Jenkin. The Department of Health reviewed its surviving documentation evidence from the period when the decision to pursue self-sufficiency was made and found no evidence to suggest that the hepatitis C outbreak in the late 1970s and early 1980s in this country could have been avoided if self-sufficiency had been achieved. In other words, the issue was one of science. By the early 1980s there was evidence that commercial provision, from the United States, and UK plasma concentrates carried a similar risk of transmitting hepatitis. The review was published in 2006 and is available on the Department of Health website. The noble Baroness, Lady Barker, referred to the look-back exercise. The Department of Health has agreed to fund such an exercise to ascertain whether patients not already identified with bleeding disorders might have been infected. The work is currently under way with the United Kingdom Haemophilia Centre Doctors’ Organisation to put this in place. It will take a while to trace all these patients, but we hope to be able to report on progress in the summer of 2010. I hope that noble Lords will not think that my remarks suggest that this Government are not listening or not taking action. We certainly regard the Haemophilia Society and the Haemophilia Alliance as partners in the progress that we need to make on this very important issue. We have put our money where our mouth is. I also recognise that this is never enough. The noble Baroness, Lady Barker, as ever, pointed to moral, realistic and practical questions. In conclusion, many of the provisions in the Bill are either already in place, or are being put in place. Because of that, we believe that there is no need for recourse to legislation on this issue. I have also pointed to some technical issues regarding the Bill. I know that the arrangements that are in place might not always be as far-reaching as some noble Lords wish they would be. We need continually to strive to improve services for haemophilia patients and others affected by this tragedy. It is only right that I should finish by restating on behalf of the Government my deepest sympathy for those affected by this tragedy and restating our continuing efforts on their behalf.